MEDICARE: REHABILITATION SERVICES OF SOUTHWEST LOUISIANA, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1366777229
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHABILITATION SERVICES OF SOUTHWEST LOUISIANA, LLC

Provider Business Mailing Address
First Line	:	1000 CHINABERRY DR STE 900
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-2455
Country	:	US
Telephone Number	:	318-746-0420
Fax Number	:	318-626-5429

Provider Business Practice Location Address
First Line	:	751 BAYOU PINES EAST DR STE C
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-7196
Country	:	US
Telephone Number	:	337-433-3292
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	MR. KYLE JACOB
Credential	:
Telephone Number	:	318-746-0420

Provider Enumeration Date	:	10/11/2009
Last Update Date	:	07/24/2023

Similar Medicare Providers

1972451987 — MRS. HANNAH LEJEUNE GETTYS MSW, LMSW
Practice Location Address:

751 BAYOU PINES EAST DR STE C
LAKE CHARLES, LA
70601-7196

Practice Phone: 337-433-3292
Practice Fax: 337-433-3293

1295683787 — DWAYNE MORRIS JR.
Practice Location Address:

751 BAYOU PINES EAST DR
LAKE CHARLES, LA
70601-7196

Practice Phone: 337-429-5183
Practice Fax:

1427038827 — JOHN L SCOTT CRNA
Practice Location Address:

751 E BAYOU PINES DR , SUITE L
LAKE CHARLES, LA
70601-7196

Practice Phone: 337-436-8700
Practice Fax: 337-433-5942

1013997410 — MICHAEL T SHANDERSKY CRNA
Practice Location Address:

751 E BAYOU PINES DR , SUITE L
LAKE CHARLES, LA
70601-7196

Practice Phone: 337-436-8700
Practice Fax: 337-433-5942

1306021282 — JOHN SHANE MALLETT CRNA
Practice Location Address:

751 BAYOU PINES EAST DR , SUITE L
LAKE CHARLES, LA
70601-7196

Practice Phone: 337-436-8700
Practice Fax: 337-436-3008

1255655239 — REJUVENATE HEALTH CHIROPRACTIC
Practice Location Address:

751 BAYOU PINES EAST DR , SUITE R
LAKE CHARLES, LA
70601-7196

Practice Phone: 337-802-6497
Practice Fax:

Directions to “REHABILITATION SERVICES OF SOUTHWEST LOUISIANA, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.